Initial staging examinations for head and neck squamous cell carcinoma: are they appropriate?

Department of Otorhinolaryngology - Head and Neck Surgery, Medical University Innsbruck, Innsbruck, Austria.

Abstract

OBJECTIVES:

The presence of distant metastases affects the therapeutic regime in patients with head and neck squamous cell carcinoma. This study evaluated the necessity to undertake bone scanning, chest computed tomography and abdominal ultrasonography in patients presenting with primary advanced head and neck squamous cell carcinoma.

STUDY DESIGN:

Retrospective analysis, university setting.

METHODS:

One hundred and sixty-three patients with head and neck squamous cell carcinoma who were scheduled for major surgery underwent screening for distant metastases. Chest, head and neck computed tomography, abdominal ultrasonography and bone scanning were performed in all patients.

RESULTS:

Distant metastases were detected in 5.52 per cent of the 163 patients. All of these patients had locoregional advanced (stage IV) tumours. Computed tomography scanning of the lungs revealed metastases in six patients. Bone metastases were found in three patients. Only one patient with primary liver metastases was detected by abdominal ultrasonography; this patient also had pulmonary metastases.

CONCLUSIONS:

Computed tomography of the thorax is the most important technique for screening patients with head and neck squamous cell carcinoma.